Individual
MS. CINDY J WAGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
258 MEADOW DR, DANVILLE, IN 46122
(317) 718-0605
(317) 718-0720
Mailing address
258 MEADOW DR, DANVILLE, IN 46122
(317) 718-0605
(317) 718-0720
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
34003577A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000378933
ANTHEM BCBS
—
01
—
11487765
CAQH
—
Enumeration date
07/12/2006
Last updated
07/08/2007
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